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Individual

DR. KAYNESSA CELENA PROVIDENCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
54 TOWER RD NE, MARIETTA, GA 30060-6977
(770) 427-4682
(770) 499-8562
Mailing address
54 TOWER RD NE, MARIETTA, GA 30060-6977
(770) 427-4682
(770) 499-8562

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
86204
GA

Other

Enumeration date
04/10/2015
Last updated
08/18/2022
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